Application Value Of Contrast-enhanced Ultrasonography In Renal Space Occupying Lesions

Objective:To explore the application value about contrast enhanced ultrasound in renal space occupying lesion with different pathology types.Methods:85patients with92lesions who suffered from kidney space occupying lesion were evaluated by traditional ultrasound and contrast enhanced ultrasound (CEUS). The enhanced feathers, homogeneity and pseudocapsule sign between malignant and benign lesions were analyzed. There were62malignant lesions and30benign lesions. According to the difference of echo intensity between the lesion areas and the surrounding renal cortical, CEUS mode were divided into4types:type Ⅰ "quick in and out":lesions area enhanced more earlier than or equal to renal cortex,and swept away more earlier than renal cortex; type Ⅱ "quick in and slow out", lesions area enhanced earlier and swept away slower than renal cortex; type Ⅲ "slow in and out":lesions area enhanced and swept away slower than renal cortex; type Ⅳ "Simultaneous in and out":lesion areas enhanced and swept away in all phase with renal cortex.Results:In the62malignant lesions, there were31"quick in slow out",21"quick in slow out",7"slow in and out" and3"Simultaneous in and out". In the30benign lesions, there were4"quick in slow out",7"quick in slow out",11"slow in and out",7"Simultaneous in and out" and1benign lesions have no enhance in diseased region, which was "no in and out", so the difference of enhance type between malignant lesions and benign lesions had statistical meaning (χ2=22.461, P=0.000). Enhance echo were divided into homogeneous enhancement and inhomogeneous enhancement, according to their distribution. In the malignant lesions, there were41inhomogeneous enhancements. In the benign lesions, there were3inhomogeneous enhancements. It meant that the difference of CEUS evenness between malignant and benign lesions had statistical significance(χ2=31.326, P=0.000). Narrow ring high echo around lesion is defined as pseudocapsule sign. In the62malignant lesions,38showed pseudocapsule sign and no benign lesions showed this sign, which had statistical difference(χ2=25.526,P=0.000).Conclusion:The contrast enhanced ultrasound has significant value to differentiate malignant from benign lesions of kidney occupying lesion.